Specific Aims. Specific Aim 1: To determine if there are racial differences in the level of insight among individuals with schizophrenia and to explore the influence of possible confounding factors, such as education, on the relationship between race and insight. Specific Aim 2: To explore relationships between level of insight and treatment utilization and outcomes among individuals with schizophrenia. Focus: to investigate whether there are racial differences in the level of insight among individuals with schizophrenia and to explore whether these differences are associated with differential outcomes. The quality of care provided to patients with schizophrenia is inadequate and in particular for minorities. Reasons for provision of poor quality of care to people with schizophrenia are not well understood. One commonly cited contributor is the assumption of a patient's lack of insight into their illness and need for participation in care. Insight is most commonly defined as a multidimensional construct that includes awareness of illness, attribution of symptoms and perceived need for treatment. Insight has been shown to predict non-adherence with treatment, poor prognosis, and poorer longer-term outcomes including increased numbers of hospitalizations. A recent study suggests a relationship between level of insight and suicidality. It is possible that one's culture could influence each aspect of insight, ultimately leading to different interpretations of what level of insight a person has into mental illness. Indeed, some cultures attribute symptoms of mental illness to spiritual discourse while others may attribute it to biological malfunction. In addition, if a patient's understanding of the etiology of the illness is different from the clinicians, by extension, they may also take issue with the recommended treatment or see no need for treatment at all. Although not a consistent finding in the literature, some research suggests that minorities are described as having poor insight more often than their Caucasian counterparts.